# Study of the predictive value of testosterone in androgen deprivation therapy for metastatic hormone-sensitive prostate cancer—the dual clinical research center for western and eastern China

## TL;DR

This study finds that testosterone levels after one month of treatment can predict survival outcomes in prostate cancer patients.

## Contribution

The study identifies ultra-low testosterone levels as a novel predictor for improved survival in metastatic hormone-sensitive prostate cancer.

## Key findings

- Patients with ultra-low testosterone after treatment had better survival outcomes.
- Non-responders had higher tumor load and faster progression to resistant cancer.
- Testosterone response groups showed no baseline characteristic differences but varied in survival.

## Abstract

This study aims to investigate the association between early testosterone (T) response to androgen deprivation therapy (ADT) and clinical outcomes in metastatic hormone-sensitive prostate cancer (mHSPC).

This retrospective cohort study analyzed 366 mHSPC patients treated at The People’s Hospital Bozhou and The First Affiliated Hospital of Xinjiang Medical University. The participants were stratified by 1-month testosterone response: response group (T < 50 ng/dL) and non-response group (T > 50 ng/dL). The response group was further subdivided into ultra-low (T < 20 ng/dL) and low (20–50 ng/dL) response groups. Comparative analyses of baseline characteristics, progression to metastatic castration-resistant prostate cancer (mCRPC), and survival outcomes were carried out.

No significant intergroup differences were observed in Gleason score, tumor stage, prostate volume, initial PSA, PSA density, perineural invasion, visceral metastasis, or hazard level (all P > 0.05). However, the T non-response group exhibited a higher tumor load prevalence (76.77% vs. 60.10%, P = 0.004). The T non-response group demonstrated shorter mCRPC progression time (13.38 ± 8.88 vs. 20.40 ± 11.91 months, P < 0.001), though no difference emerged between the T ultra-low and low response subgroups (20.59 ± 11.91 vs. 20.86 ± 12.19 months, P = 0.876). Survival analysis revealed superior 3-year survival in T responders (P = 0.024), with T ultra-low responders showing significant advantages in both overall survival (P = 0.010) and 3-year survival (P = 0.001) compared to T low responders.

Ultra-low T levels (<20 ng/dL) after 1-month ADT can be used as a reference standard for predicting survival outcomes and may guide treatment optimization in mHSPC.